Ohio GED Transcript Request and Release of Information Form

							                                 Ohio GED Transcript Request
                                and Release of Information Form

   1. Security Number (Social Security number or number used when testing):
                       •          •

   2.   *Name of GED student (current):
   3.   Street address (current):                                                        Apt.:
   4.   City:                                               State:                       ZIP:
   5.   Day Phone Number (          )                  -                        Date of Birth:
   6.   City and State where student tested:                                            Year tested:
   7.   Name(s) when tested (if different than above):
   NOTE: If you are requesting that we send a transcript to the above address, skip question 8.

   8. Send transcript to (if not to yourself):
      Business Name:
      Attn. Name:
      Street Address:
      City:                                                 State:                        ZIP:



                           FEES AND REQUIREMENTS                  MONEY ORDERS ONLY

Only Money Orders (payable to Ohio Testing Services) are accepted and must be sent with this request.
                                   NOTE: FEE IS NON-REFUNDABLE
CHOOSE ONE:

   #1 Standard Service ($5.00): Transcript is processed (first class mail) within 7-10 business days of receipt in
     the GED Office; or

   #2 Priority/Faxing Service ($10.00): (YOU MUST WRITE “PRIORITY PROCESSING” ON THE FRONT
     OF THE ENVELOPE). Transcript is processed, faxed (if requested) and mailed first class.
        L L




        Fax number if you are requesting fax service: (             )               -
        Attention: Name                                                Title
         The transcript will be faxed before mailing if you check the box above and give a valid fax number.


  *The GED student listed above must sign and date this release of information form.

  I, the undersigned, consent to the release of my GED records.

  X                                                                               Date:
    Signature of GED Student

  Send completed form and money order to this address: GED Transcript Office
                                                       25 South Front Street, 1st Floor
                                                       Columbus, Ohio 43215-4183

  NOTE: MAKE MONEY ORDER PAYABLE TO: OHIO TESTING SERVICES
                                                                                                           Rev. 01/01/06